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Incremental advances and game-changing innovation in medtech

Medical technology development is driven by a variety of factors. The most common drivers are to extend or improve the capabilities of existing technologies:

Addressing under-served clinical need

enabling treatment of “untreatable” patient types

enabling shift of procedures to outpatient or doctors’ offices

Reducing cost

less expensive device

faster healing time

Improving performance

reducing operating time

lowering the rate of complications

These drivers underscore much activity in medical technology development, since they typically focus on designing products that are improvements upon existing, FDA-approved or CE-Mark technologies. The hurdles to these developments are (relatively) few, requiring little more than being able to construct an argument that a newly developed medical product provides a feature that is “better” than available technologies. (This, of course, represents the putative reason for high healthcare costs, with only nominally “new” technologies commanding price premiums over established ones, but that is the focus of a different discussion.)

In reviewing the formation of new medtech companies that we have recorded in our data over the past three years, there are a number of very common drivers:

- development of surgical instrumentation for use in laparoscopic surgery, single-incision (or single-port) laparoscopy, NOTES (arguably, NOTES is not a radically new approach but the embodiment of what “minimally invasive” endoscopy is when pushed to its logical limits) and other endoscopy .

Among the less common of these technologies are those that emerge from the application of a fundamentally different approach to healthcare (call it “paradigm shift” or “game-changing” or whatever your preferred buzz-term). These technologies consider treatment from a very different perspective that fundamentally change the rules of the game. To some degree, radical change stems simply from the emergence of a new technology that enables radically different treatment, such as the use of stem cells to restore pancreatic function in diabetes. In other cases, medtech manufacturers have recognized the law of diminishing returns in pursuing incremental innovation of established technologies and have instead forged entirely new paths to treatment, as in the use of neuromodulation for pain management (and other clinical end-points) or transcatheter procedures to replace invasive cardiovascular surgery.

Examples of game-changing technologies:

Transcatheter alternatives to surgery

Treatment of hypertension via ablation of sympathetic nerve

Neuromodulation or neurostimulation for relief of chronic pain or treatment of hypertension and other conditions

In the end, the bulk of medtech developments arise from innovative improvements on existing technologies to create competitive advantage, but the mistake for any current market participant is to not remain vigilant in considering the developments of current or potential competitors pursuing radical alternatives to more effectively satisfy clinical (and economic) need.

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P. Driscoll

Patrick Driscoll founded MedMarket Diligence and has become a leading source of analysis and insight in medical technology markets. He previously co-founded Medtech Insight and was a principal at Medical Data International. He has 25 years of experience assessing current and potential markets for medical technologies.
View all posts by P. Driscoll